scholarly journals Augmented Reality for Guideline Presentation in Medicine: A Crossover Simulation Trial for Technically Assisted Decision-making (Preprint)

2019 ◽  
Author(s):  
Andreas Follmann ◽  
Alexander Ruhl ◽  
Michael Gösch ◽  
Marc Felzen ◽  
Rolf Rossaint ◽  
...  
Keyword(s):  
Augmented Reality ◽  
Mass Casualty Incident ◽  
Modern Medicine ◽  
Mass Casualty ◽  
Tablet Pc ◽  
Additional Time ◽  
Smart Glasses ◽  
Significant Difference ◽  
The Difference ◽  
Time Critical

BACKGROUND Guidelines provide instructions for diagnostics and therapy in modern medicine. Various mobile devices are used to represent the potential complex decision trees. An example of time-critical decisions is triage in case of a mass casualty incident. OBJECTIVE In this randomized controlled cross-over study, the potential of augmented reality for guideline presentation was evaluated and compared with a tablet PC as a conventional device. METHODS A specific Android app was designed for use with Smart Glasses as well as with a tablet PC for presentation of a triage algorithm as an example for a complex guideline. 40 volunteers simulated a triage based on 30 fictional patient descriptions each, with technical support from data glasses and a tablet PC in cross-over trial design. The time to come to a decision and the accuracy were recorded and compared between the different devices. RESULTS A total of 2400 assessments were performed. A significantly faster triage time has been achieved with the tablet PC (12.8 sec) compared to the smart glasses (17.5 sec; P = .001) in total. Considering the difference in triage duration between both devices, the additional time needed with the smart glasses could be reduced significantly in the course (P = .001). In accuracy of guideline decisions, there was no significant difference comparing both devices. CONCLUSIONS The presentation of a guideline on a tablet computer, as well as in the form of augmented reality, achieved good results. The implementation using smart glasses took more time due to a more complex operating concept but could be accelerated in the course of the study after adaptation. Especially in a non-time-critical working area where hands-free interfaces are meaningful, a guideline presentation with augmented reality can already be implemented.

scholarly journals Technical Support by Smart Glasses During a Mass Casualty Incident: A Randomized Controlled Simulation Trial on Technically Assisted Triage and Telemedical App Use in Disaster Medicine (Preprint)

2018 ◽  
Author(s):  
Andreas Follmann ◽  
Marian Ohligs ◽  
Nadine Hochhausen ◽  
Stefan K Beckers ◽  
Rolf Rossaint ◽  
...  
Keyword(s):  
Augmented Reality ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Disaster Medicine ◽  
Technical Support ◽  
Control Group ◽  
Smart Glasses ◽  
Android App ◽  
Triage Algorithm

BACKGROUND To treat many patients despite lacking personnel resources, triage is important in disaster medicine. Various triage algorithms help but often are used incorrectly or not at all. One potential problem-solving approach is to support triage with Smart Glasses. OBJECTIVE In this study, augmented reality was used to display a triage algorithm and telemedicine assistance was enabled to compare the duration and quality of triage with a conventional one. METHODS A specific Android app was designed for use with Smart Glasses, which added information in terms of augmented reality with two different methods—through the display of a triage algorithm in data glasses and a telemedical connection to a senior emergency physician realized by the integrated camera. A scenario was created (ie, randomized simulation study) in which 31 paramedics carried out a triage of 12 patients in 3 groups as follows: without technical support (control group), with a triage algorithm display, and with telemedical contact. RESULTS A total of 362 assessments were performed. The accuracy in the control group was only 58%, but the assessments were quicker (on average 16.6 seconds). In contrast, an accuracy of 92% (P=.04) was achieved when using technical support by displaying the triage algorithm. This triaging took an average of 37.0 seconds. The triage group wearing data glasses and being telemedically connected achieved 90% accuracy (P=.01) in 35.0 seconds. CONCLUSIONS Triage with data glasses required markedly more time. While only a tally was recorded in the control group, Smart Glasses led to digital capture of the triage results, which have many tactical advantages. We expect a high potential in the application of Smart Glasses in disaster scenarios when using telemedicine and augmented reality features to improve the quality of triage.

Impact of a Two-step Emergency Department Triage Model with START, then CTAS, on Patient Flow During a Simulated Mass-casualty Incident

2015 ◽  
Vol 30 (4) ◽  
pp. 390-396 ◽  
Author(s):  
James S. Lee ◽  
Jeffrey M. Franc
Keyword(s):  
Emergency Department ◽  
Patient Flow ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Mean Difference ◽  
Time Intervals ◽  
Simulation Exercise ◽  
Physician Assessment ◽  
Emergency Department Triage ◽  
The Difference

AbstractIntroductionA high influx of patients during a mass-casualty incident (MCI) may disrupt patient flow in an already overcrowded emergency department (ED) that is functioning beyond its operating capacity. This pilot study examined the impact of a two-step ED triage model using Simple Triage and Rapid Treatment (START) for pre-triage, followed by triage with the Canadian Triage and Acuity Scale (CTAS), on patient flow during a MCI simulation exercise.Hypothesis/ProblemIt was hypothesized that there would be no difference in time intervals nor patient volumes at each patient-flow milestone.MethodsPhysicians and nurses participated in a computer-based tabletop disaster simulation exercise. Physicians were randomized into the intervention group using START, then CTAS, or the control group using START alone. Patient-flow milestones including time intervals and patient volumes from ED arrival to triage, ED arrival to bed assignment, ED arrival to physician assessment, and ED arrival to disposition decision were compared. Triage accuracy was compared for secondary purposes.ResultsThere were no significant differences in the time interval from ED arrival to triage (mean difference 108 seconds; 95% CI, -353 to 596 seconds; P=1.0), ED arrival to bed assignment (mean difference 362 seconds; 95% CI, -1,269 to 545 seconds; P=1.0), ED arrival to physician assessment (mean difference 31 seconds; 95% CI, -1,104 to 348 seconds; P=0.92), and ED arrival to disposition decision (mean difference 175 seconds; 95% CI, -1,650 to 1,300 seconds; P=1.0) between the two groups. There were no significant differences in the volume of patients to be triaged (32% vs 34%; 95% CI for the difference -16% to 21%; P=1.0), assigned a bed (16% vs 21%; 95% CI for the difference -11% to 20%; P=1.0), assessed by a physician (20% vs 22%; 95% CI for the difference -14% to 19%; P=1.0), and with a disposition decision (20% vs 9%; 95% CI for the difference -25% to 4%; P=.34) between the two groups. The accuracy of triage was similar in both groups (57% vs 70%; 95% CI for the difference -15% to 41%; P=.46).ConclusionExperienced triage nurses were able to apply CTAS effectively during a MCI simulation exercise. A two-step ED triage model using START, then CTAS, had similar patient flow and triage accuracy when compared to START alone.LeeJS, FrancJM. Impact of a two-step emergency department triage model with START, then CTAS, on patient flow during a simulated mass-casualty incident. Prehosp Disaster Med. 2015;30(4):1–7.

Comparison of Unmanned Aerial Vehicle Technology-Assisted Triage versus Standard Practice in Triaging Casualties by Paramedic Students in a Mass-Casualty Incident Scenario

2018 ◽  
Vol 33 (4) ◽  
pp. 375-380 ◽  
Author(s):  
Trevor Jain ◽  
Aaron Sibley ◽  
Henrik Stryhn ◽  
Ives Hubloue
Keyword(s):  
Unmanned Aerial Vehicle ◽  
Prince Edward Island ◽  
Motor Vehicle ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Evacuation Time ◽  
Standard Practice ◽  
Time To Completion ◽  
Significant Difference ◽  
Aerial Vehicle

AbstractIntroductionThe proliferation of unmanned aerial vehicle (UAV) technology has the potential to change the way medical incident commanders (ICs) respond to mass-casualty incidents (MCIs) in triaging victims. The aim of this study was to compare UAV technology to standard practice (SP) in triaging casualties at an MCI.MethodsA randomized comparison study was conducted with 40 paramedic students from the Holland College Paramedicine Program (Charlottetown, Prince Edward Island, Canada). Using a simulated motor vehicle collision (MVC) with moulaged casualties, iterations of 20 students were used for both a day and a night trial. Students were randomized to a UAV or a SP group. After a brief narrative, participants either entered the study environment or used UAV technology where total time to triage completion, GREEN casualty evacuation, time on scene, triage order, and accuracy were recorded.ResultsA statistical difference in the time to completion of 3.63 minutes (95% CI, 2.45 min-4.85 min; P=.002) during the day iteration and a difference of 3.49 minutes (95% CI, 2.08 min-6.06 min; P=.002) for the night trial with UAV groups was noted. There was no difference found in time to GREEN casualty evacuation, time on scene, or triage order. One-hundred-percent accuracy was noted between both groups.Conclusion:This study demonstrated the feasibility of using a UAV at an MCI. A non-clinical significant difference was noted in total time to completion between both groups. There was no increase in time on scene by using the UAV while demonstrating the feasibility of remotely triaging GREEN casualties prior to first responder arrival.Jain T, Sibley A, Stryhn H, Hubloue I.Comparison of unmanned aerial vehicle technologyassisted triage versus standard practice in triaging casualties by paramedic students in a mass-casualty incident scenario. Prehosp Disaster Med. 2018;33(4):375–380

First Responder Accuracy Using SALT during Mass-casualty Incident Simulation

2016 ◽  
Vol 31 (2) ◽  
pp. 150-154 ◽  
Author(s):  
Christopher W.C. Lee ◽  
Shelley L. McLeod ◽  
Kristine Van Aarsen ◽  
Michelle Klingel ◽  
Jeffrey M. Franc ◽  
...  
Keyword(s):  
Primary Care ◽  
Motor Vehicle ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Medical Attention ◽  
First Responder ◽  
Publication Type ◽  
Fire Science ◽  
Significant Difference ◽  
Second Year

AbstractIntroductionDuring mass-casualty incidents (MCIs), patient volume often overwhelms available Emergency Medical Services (EMS) personnel. First responders are expected to triage, treat, and transport patients in a timely fashion. If other responders could triage accurately, prehospital EMS resources could be focused more directly on patients that require immediate medical attention and transport.HypothesisTriage accuracy, error patterns, and time to triage completion are similar between second-year primary care paramedic (PCP) and fire science (FS) students participating in a simulated MCI using the Sort, Assess, Life-saving interventions, Treatment/Transport (SALT) triage algorithm.MethodsAll students in the second-year PCP program and FS program at two separate community colleges were invited to participate in this study. Immediately following a 30-minute didactic session on SALT, participants were given a standardized briefing and asked to triage an eight-victim, mock MCI using SALT. The scenario consisted of a four-car motor vehicle collision with each victim portrayed by volunteer actors given appropriate moulage and symptom coaching for their pattern of injury. The total number and acuity of victims were unknown to participants prior to arrival to the mock scenario.ResultsThirty-eight PCP and 29 FS students completed the simulation. Overall triage accuracy was 79.9% for PCP and 72.0% for FS (∆ 7.9%; 95% CI, 1.2-14.7) students. No significant difference was found between the groups regarding types of triage errors. Over-triage, under-triage, and critical errors occurred in 10.2%, 7.6%, and 2.3% of PCP triage assignments, respectively. Fire science students had a similar pattern with 15.2% over-triaged, 8.7% under-triaged, and 4.3% critical errors. The median [IQR] time to triage completion for PCPs and FSs were 142.1 [52.6] seconds and 159.0 [40.5] seconds, respectively (P=.19; Mann-Whitney Test).ConclusionsPrimary care paramedics performed MCI triage more accurately than FS students after brief SALT training, but no difference was found regarding types of error or time to triage completion. The clinical importance of this difference in triage accuracy likely is minimal, suggesting that fire services personnel could be considered for MCI triage depending on the availability of prehospital medical resources and appropriate training.LeeCWC, McLeodSL, Van AarsenK, KlingelM, FrancJM, PeddleMB. First responder accuracy using SALT during mass-casualty incident simulation. Prehosp Disaster Med. 2016;31(2):150–154.

scholarly journals P074: Comparison of unmanned aerial vehicle technology versus standard practice in triaging casualties by paramedic students in a mass casualty incident scenario

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S83-S83 ◽  
Author(s):  
T. Jain ◽  
A. Sibley ◽  
H. Stryhn ◽  
I. Hubloue
Keyword(s):  
Unmanned Aerial Vehicle ◽  
Motor Vehicle ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Evacuation Time ◽  
Standard Practice ◽  
Vehicle Collision ◽  
Significant Difference ◽  
Aerial Vehicle ◽  
Percent Accuracy

Introduction: The proliferation of unmanned aerial vehicle (UAV) technology has the potential to change the way medical incident commanders respond to mass casualty incidents (MCI) in triaging victims. The aim of this study was to compare UAV technology to standard practice (SP) in triaging casualties at a MCI Methods: A randomized comparison study was conducted with forty paramedic students from the Holland College Paramedicine Program. Using a simulated motor vehicle collision with moulaged casualties, iterations of twenty students were used for both a day and a night trial. Students were randomized to an UAV or a SP group. After a brief narrative participants either entered the study environment or used UAV technology where total time to triage completion, green casualty evacuation, time on scene, triage order and accuracy was recorded Results: A statistical difference in the time to completing of 3.63 minutes (95% CI: 2.45, 4.85, p=0.002) during the day iteration and a difference of 3.49 minutes (95% CI: 2.08,6.06, p=0.002) for the night trial with UAV groups was noted. There was no difference found in time to green casualty evacuation, time on scene or triage order. One hundred percent accuracy was noted between both groups. Conclusion: This study demonstrated the feasibility of using an UAV at a MCI. A non clinical significant difference was noted in total time to completion between both groups. There was no increase in time on scene by using the UAV while demonstrating the feasibility of remotely triaging green casualties prior to first responder arrival.

scholarly journals Is there a triage sieve knowledge and application gap between clinical team leaders and their team members?

2019 ◽  
Vol 16 ◽  
Author(s):  
Glen Cuttance ◽  
Kathryn Dansie ◽  
Timothy Rayner
Keyword(s):  
Intervention Group ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Control Group ◽  
Theoretical Knowledge ◽  
Clinical Team ◽  
Team Leaders ◽  
Team Members ◽  
Significant Difference ◽  
Accuracy Rates

IntroductionAmbulance service team leaders may be required to provide organisational leadership at complex incidents, such as a mass-casualty incident involving triage sieve. It may be expected that team leaders have a greater understanding of, and should be able to better apply their skills, than their team members during such an incident. The objective of this study was to determine if team leaders have a higher theoretical knowledge and better triage sieve application skills than their team members.MethodsTeam leaders were allotted into one of two groups: the first (control) group completed a questionnaire without any supporting documentation (ie. aide-memoir), whereas the second (intervention) group completed the same questionnaire, as the control group, but utilising supportive documentation.ResultsThe results show that the team leaders from the control group achieved significantly better results than their team members when completing a questionnaire, without the use of supportive documentation. There was no significant difference between team leaders from the intervention group and their team members when completing the same questionnaire using supportive documentation.ConclusionIt has been shown that the use of printed supportive material in the form of an aide-memoir decreases the knowledge and application gap between team leaders and their team members, and increases triage sieve accuracy. The results from this study reinforces the results from previous studies, showing that supporting documentation should be used to ensure greater triage sieve accuracy rates and thereby reducing under- and over-triage rates.

scholarly journals The Design and Implementation of an Educational Augmented Reality Application for Logical Circuit Design

2020 ◽  
Vol 9 (1) ◽  
pp. 33-50
Author(s):  
Fatih Arıkan ◽  
Hasan Özgür
Keyword(s):  
Augmented Reality ◽  
Professional Training ◽  
Engineering Students ◽  
Maternal Education ◽  
Significant Difference ◽  
Augmented Reality Application ◽  
Before And After ◽  
Education Status ◽  
The Usa ◽  
The Difference

The purpose of the study is to determine the effect of augmented reality applications on the learning of engineering students in their professional courses. The objective of the study is to ensure that augmented reality technologies, which are among the most important technologies of today, are used in educational settings. The other important objective of the study is to ensure that the augmented reality technologies used in professional training in countries such as the USA, Canada and the Netherlands are also used in our country and to provide a world-class education opportunity. Also, contributing to the economy of our country with the successful studies to be carried out in this regard is among the objectives of the study because of the increasing interest in augmented reality software throughout the world and the formation of an important economy related to the development of these kinds of software.In the study, an augmented reality application developed by the researcher was used in the learning process of a subject included in the faculty of engineering education curriculum. The study was performed using a convergent parallel mixed-methods design in which both qualitative and quantitative data were used simultaneously. The result of the study showed that there were no significant difference between the average attitude towards AR applications of the students participating in the study and the gender, class, and father education level; however, it is seen that there was a significant difference between maternal education status. It was also determined that the difference between the students’ average attitude towards AR applications before and after the study was significant.Similarly, it was observed that the difference between the AR attitude averages before and after the study and the AG attitude average 4 weeks after the study was also observed to be significant. It was also found that the students who participated in the study found the AR applications remarkable, entertaining, understandable and useful for the instructor. Moreover, they stated that using AR applications in lessons would contribute to fast and active learning and increase success.

Difference in First Aid Activity During Mass Casualty Training Based on Having Taken an Educational Course

2017 ◽  
Vol 12 (4) ◽  
pp. 437-440
Author(s):  
Youichi Yanagawa ◽  
Kazuhiko Omori ◽  
Kouhei Ishikawa ◽  
Ikuto Takeuchi ◽  
Kei Jitsuiki ◽  
...  
Keyword(s):  
Life Support ◽  
Initial Period ◽  
Fire Department ◽  
First Aid ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Disaster Medicine ◽  
Ambulance Service ◽  
Medical Practitioners ◽  
The Difference

ABSTRACTBackgroundThe Japanese Association for Disaster Medicine developed a mass casualty life support (MCLS) course to improve cooperation among medical practitioners during a disaster, which is essential for reducing the rates of preventable disaster death. We investigated whether there was difference in first aid activity among members of the ambulance service during mass casualty training based on having taken the MCLS course.MethodsMass casualty training was held at the fire department of Numazu City. Twenty-one ambulance service parties participated in this training. They first evaluated the mass casualty situation, performed the appropriate services at the scene during the initial period, and then provided START triage for mock wounded patients. Throughout the training, 5 examiners evaluated their performance.ResultsRegarding the difference in first aid activity based on MCLS course attendance among the ambulance service members, the cooperative management (scored on a scale of 1 to 5) among the members who had taken the MCLS course was significantly better than that among those who had not taken the course (median [interquartile range]: 5 [0.5] vs. 4 [1.75], P<0.05).ConclusionAttending an MCLS course may help to improve outcomes in the face of an actual mass casualty incident. (Disaster Med Public Health Preparedness. 2018;12:437–440)

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